The present invention relates to the safety of endotracheal intubation in patient airway management, and more particularly to a dual function endotracheal tube holder which is employed in securing an endotracheal tube and protecting it from movement, dislodgement and being bitten by the patient, hence to ensure the patient's airway during surgery as well as in postoperative or other intensive care units/areas, or in any situation where patient's airway needs to be secured or protected. Employing the present invention will prevent all above mentioned complications which can be life-threatening or fatal.
Endotracheal intubation, placement of a tube into the trachea, is an integral part of airway management in modern-day medical practice. It plays a vital role and has the first priority in unconscious patients, patients under or emerging from general anesthesia, victims require acute resuscitation, and various patients need chronic or critical intensive medical care. Endotracheal intubation is the most rapid and usually the easiest method to ensure a patent airway. It has, therefore, earned its popularity in anesthesia practice as well as in emergency medicine and intensive care units/areas. The advantages of endotracheal intubation are many. Since patency of the airway is assured, aspiration is prevented and secretions may be removed with relative ease from the tracheobronchial tree. Positive pressure ventilation, either manual or mechanical, can be applied to the airway for better control of ventilation and oxygen supply.
However, endotracheal intubation does not guarantee a patent airway. The endotracheal tube may be kinked, dislodged, or accidently extubated or being bitten by the patient, particularly when the patient is semiconscious and not paralyzed. The situations are usually fatal particularly when a wire reinforced endotracheal tube is used. A wire reinforced endotracheal tube is generally employed due to concern that external pressure or the head/neck position may compress the airway. A distorted airway may be difficult to re-intubate. A reinforced endotracheal tube will maintain its shape better than a plastic non-reinforced one. However, once the metal in a reinforced tube has been bent out of shape, it remains pinched or collapsed, which leaves the patient in a more dangerous predicament.
After intubation, patient's airway is reasonably secured but not guaranteed. Failure to fasten an endotracheal tube properly may cause dislodgment or displacement of the tube, or even accidental extubation. These complications usually are life- threatening or even fatal. Continued improvement in equipment have prevented many of the associated complications. Nonetheless, tube collapse/occlusion by patient's biting are still the main unsolved problem. However, they can be avoid or eliminated by equipment design.
Currently, a Guedel oral airway, a curved device to be inserted into the mouth, as shown in FIG. 5, is employed to prevent patient's biting. As shown in FIG. 6, an endotracheal tube is conventionally secured employing adhesive tape together with a Guedel oral airway. Shortcomings in this method are that this oral airway may fail to serve its purpose as a bite-block. Since only the short distal straight portion of the modem plastic disposable oral airway is firm enough to prevent biting and due to its curvature the oral airway can only be placed in the midline. When the patient is semiconscious but not paralysed, he or she may be able to use the tongue to push the oral airway out and bite on its soft portion as well as on the endotracheal tube. The patient can also push the endotracheal tube between the molars and bite on it. Futhermore, when an over-sized oral airway is used, the patient may not be avle to tolerate such an aid. Additionally, it can even cause airway obstruction by its very presence. Prolonged or improper use of oral airway can cause trauma and infection of oropharyngeal tissues, and subsequently increase hospital days and costs.
As shown in FIG. 6, the conventional Guedel oral airway described above is generally secured with adhesive tape to the patient's mouth that the adhesion of the Guedel oral airway in proper position can not last long. Especially, to some patients who have beard or have oily or hairy skin, the tape adhesion is unreliable and may cause danger to the patients.
The introduction of the present invention as described herein will eliminated all these problems. The herein described invention has a great promise as a major advancement in airway management which plays a vital role in modem medicine.